Qu.1 The patient has a compound fracture of the lower leg, with bleeding and soft tissue damage. Neurological assessment should be made distal to the break to check for nerve damage. Blood loss should be estimated from visible bleeding and degree of swelling of the broken limb. Care should be taken when moving the patient to avoid further injury to the limb or damage to nerves.
Qu.2 The patient will need antibiotics to prevent infection, and careful attention should be paid to cleaning the wound area. The wound area should be kept covered with a light dressing which will prevent infection from airborne microbes without putting any pressure on the wound. A frame may be placed over the leg so that the bed sheet does not actually touch the leg. The leg should be kept immobilized until more permanent immobilization is achieved through a cast or a splint.
Qu.3 RussellÆs traction is composed of BuckÆs extension
on the lower leg using the BuckÆs boot (Skin, 2003). Nurses must inspect the traction equipment every shift to ensure traction cords are aligned in each pulley; cords are not stretched or frayed; knots are tied tightly and secured with tape; cords are hanging free of the bed and floor; weights are hanging free of the bed and floor; the correct amounts of weight are hanging; spreaders, foot plates, splints are not touching the bed; and the bed linen is not interfering with the line of traction. Correct body alignment must be maintained and proper bed position for counter traction, if needed, is maintained. Weights should be checked after position changes. A trapeze should be used to move the patient in bed, and patient should be assessed for thrombophlebitis, constipation, atelectasis and urinary problems. Pin entry/exit sites (if applicable) should be checked for redness, swelling, odor, bleeding, and discharge. Pin site care should be performed bid. When the patient is repositioned, a draw sheet ...